Spain is passing through tough economic times, and undoubtedly sacrifices need to be made to pull it out of the crisis. But at what cost? At first glance, the state budget 2012 practically puts thousands of people leaving with HIV/AIDS in Spain on a death row: funding for HIV programs has been cut to zero, from c. six million in the previous year.

Why them, why so drastically? Did people leaving with HIV/AIDS cause the economic crisis rattling Spain and most of Europe? Are there no other, less cruel, budget reductions that could have been made?

Why was the budget for the royal family only cut by 2% (c. 170,000 euro)? Could not the crown, in spirit of solidarity, let go of some of luxuries, such as hunting elephants or other animals in different parts of the world? The defence has not been particularly squeezed, either — but does Spain really face military threats? And why does the Catholic church continue receiving considerable state subsidies, in addition to enjoying a tax-free status, isn´t Spain constitutionally a secular state?

One must question the reasoning behind at the same time cutting the education budget by 20% and the health budget by 6% amounting to nearly 10 million euro. Immigrants in irregular situation are among the first on a chopping bloc being from now on denied access to healthcare save for emergency services (and make no mistake: whenever sacrifice of the most vulnerable begins, it never ends there, it goes on to require more and more victims).

Further to add an insult to injury, the Spanish government announced that it would support a failing bank with billions of euro. Thus banks, chiefly responsible for the current economic crisis, get state handouts taking funds from the innocent, in this case people with HIV/AIDS, as well as immigrants, pensioners, and young people. What´s more, the debt burden for bank bailouts is shifted onto future generations, both directly — through a growing public debt — and indirectly — through cutting educational and professional opportunities for the youth.

The 2012 budget reductions, while being necessary and perhaps inevitable, show that something is fundamentally wrong with the Spanish state´s priorities and the state has better fix them before more damage is done.

Roma health status across Europe is consistently worse than that of the majority population or even of most other ethnic groups. There is limited official data on the matter, but even scarce information that is available supports this conclusion. Infant mortality rates for Roma children are up to 4 times higher that the national averages, and Roma life expectancy is up to 10 years less than for the majority. See, for instance, a UNDP vulnerability study, and more recent surveys are also available.

Against this background it is perplexing why during health surveys so many Roma respondents estimate their health to be ´good´ or at minimum ´tolerable.´ The most logical explanation is that Roma in their majority may be simply not aware that health is more than not being terminally ill and that they have a very real, albeit unfulfilled, right to pretend to the highest attainable standard of health, with all it entails: equitable access to decent health care, including preventive care, and a host of patients´rights.

But improving Roma health indicators will take more than easing their access to cheaper and more medication, which is one concern that Roma patients most commonly raise. Medication seems like an easy solution, ridding them from the hassle, expense and humiliation of having to see a doctor. Hassle, because many do not have necessary papers or insurance; expense, because with or without insurance there is still something left to pay, if not official participation then a bribe; and humiliation, because many experience hostile attitudes from the medical personnel for a sheer reason of being Roma.

However, indicators such as high infant mortality and low life expectancy are not just about health, they are also about quality of life. Or, in case of many Roma, absence of any quality. These indicators suggest that prenatal healthcare is not adequate; that women´s health and rights are neglected; that children´s nutrition and safety are lacking. This brings about the whole issue of Roma living conditions: very often in slums, without access to clean water and sanitation, without accessible roads and very far from any health centers.

Underlying those living conditions is poverty, rooted in centuries of discrimination and exclusion. Tackling Roma health necessarily requires overhauling extremely precarious infrastructure many Roma are living in. Until then, good health for many Roma will remain but a distant prospect.